Forrest General Hospital needed to reduce the cost of prescription
drugs as part of its $25 million-plus medical plan.

Working with the hospital’s internal pharmacy staff, employeehealth and pharmacy benefits managers, Tracie McPhersonhelped it negotiate some of the nation’s lowest prescription drugcosts with a new pharmacy benefit manager while preservinggrandfathered status on the plan, said Troy Daniels, VP and CHRO, Forrest General.

For business reasons, St. Dominic Health Services switched to a TPA better known for
being a health insurance company. The transition was “an absolute mess,” said Diedra Bell,
CFO. They had problems moving data and setting up the plan in the TPA’s system.

“Tracie spent hours with the new TPA about how to administer our plan,” Bell said. “Shewent to bat for us on customer service and how to adjudicate our claims.”There’s more. To help mitigate a significant projected cost increase in its medical plan,McPherson worked with St. Dominic’s executive benefits committee to negotiate betterarrangements with a pharmacy benefit manager. The new program is on target to generatesavings of more than 20 percent on prescription drugs.

“Tracie is a strong advocate. She won’t let go until she’s found the best solution for us.”

John MejasicVoluntary Benefits SpecialistGallagher, Radnor, Pa.

Managing the Benefits Balancing Act

An employee health care program needs to balance the financial
considerations of the employer with the needs and demands of
its workers. As health care costs show no signs of coming down,
the task is often onerous and unpleasant. But for his clients,
Gallagher’s John Mejasic has demonstrated tireless effort to
make both sides happy.

When Temple University Health System wanted to offer their health plan as a group
policy as well as an individual policy, Mejasic went to every employee already enrolled in
the individual policy and helped them to assess whether they could benefit by switching
to the group plan. That level of involvement not only helped employees better understand
their options but also helped Temple maximize their health care spend so that enrollees
got the most benefits for their buck.

“He has found us some excellent deals on those programs. We’ll be rolling it out midyear, and I think it will be well-received by our employees,” said Charelle Hirsh, director of
compensation & benefits, Dr. Reddy’s Laboratories.

“We’ve also added a second opinion resource through Pinnacle Health, offered under
critical illness coverage. It’s offered remotely, so employees don’t have to travel to consult
with a second expert.”

Martin Molloy, FSAAssociate PartnerAon, Columbus, Ohio

Not Your Average Actuary

Martin Molloy, a Fellow in the Society of Actuaries, put his analytical
and mathematical skills to good use for Trelleborg Coated Systems
US, Inc. The company had inherited a pension plan from an
acquired entity that had no clear summary in its plan document.

“It was mostly boiler plate language,” said Eden Isbell, HRdirector, Trelleborg. “There were certain ways we had to calculatethings based on that language, instead of how our previous actuary had done it before.Molloy understood the plan document, and how the previous actuary had operated, andwhat we needed to be able to amend.”He brought in an ERISA attorney to make amendments to the plan document and helpedto draft new language that more accurately represented how the plan was accounted for.

“When I have questions about things I don’t understand, Martin can explain thingsclearly and thoroughly without making me feel inadequate. And he always makes himselfavailable to meet with our pension committee,” Isbell said. “He works with us and ourERISA attorney to make sure our documents are fully compliant.”He did the same for Motorists Mutual Insurance Company when it merged with anotherbusiness and needed to adjust the way it accounted for health plan costs. Motorists alsoneeded to reduce its workforce after the merger and implemented an early retirementincentive to do so, which made the accounting method change more challenging. Molloyhelped the company accurately capture costs related to paying out retirement benefits.

Regina WalshArea Vice PresidentGallagher, Philadelphia

Making the Complex Simple

Law firms have unique obligations when it comes to their benefit
structures, because partners utilize them as investment vehicles
and they may intertwine with pension plans. Managing the moving
parts requires technical expertise and the ability to explain any
changes in layman’s terms.

“We were not happy with one of our existing programs. Wewere paying a lot for insurance. Some of our partners were still underinsured. Some used itas an investment vehicle, and the investments were continually misallocated,” said RichardRowe, executive director, Wilentz, Goldman & Spitzer, P. A.

“Regina came up with three to five alternate plans and presented them to themanagement committee. She was able to establish a relaxed atmosphere from the startand earned their trust. She corrected misunderstandings that some partners had aboutboth the existing and the new product.”Ultimately, Walsh saved the firm $1.5 million in premiums by restructuring the programwithout changing or removing any of the benefits for partners.

Another law firm also needed help educating its partners about their options, especially
since the firm has a complex pension structure. Walsh came through for that firm as well,
said Dennis Foley, treasurer, Weil, Gotshal & Manges LLP.

Vali Nourishad comes through for demanding customers, said
David Henry, vice president human resources, Foundation Building
Materials — a self-described demanding customer.

Henry wanted a value-based employee benefits program. He
solicited employee comments and entertained every suggestion
as the company shrugged off its existing benefits package: Free
life insurance? Free long-term disability? Maybe.

The team had 60 days to market, select, design and roll out the program. Every juncture
allowed two hours for review, modification and vetting. Too ambitious, said a number of
brokers Henry considered. When can I start? Nourishad asked.

Despite acquisitions two weeks into the RFP that added thousands of employees and
incomplete historical data, Nourishad helped executive stakeholders make decisions in time
for a successful implementation and open enrollment.

Vesna Mardjonovic, total rewards manager, Zodiac Pool Solutions North America, is
another self-described tough customer. “I’m a New Yorker,” she explained.

Zodiac was reviewing its employee benefits from the ground up. In two weeks,
Nourishad presented 64 options for executive review. It gave employees a benefits
allowance that they could spend according to their own needs, including high- and low-deductible plans, medical, dental, vision and flexible spending accounts.

In the first year of her tenure as broker, Vernon went head-to-head with the carrier to get a 17. 9 percent overall health insurance
rate decrease, a two-year rate guarantee and a wellness incentive
that wasn’t even on the prior broker’s radar.

And because the owner “really wraps her arms” around employees, Vernon had thecarrier’s vice president on the phone regarding an employee’s spouse’s hospital admission.

Vernon also interceded in a 29-year associate’s eye surgery: “Beth arranged the visit
with the low-vision specialist,” Rice said. “She made a difference in the treatment plan.”
Her willingness to fight in the trenches makes a difference in carriers’ willingness to
cover experimental treatments, said an attorney with Babst Calland Attorneys at Law.

For example, the carrier for a shareholder’s child, who had a dismal prognosis for
muscular dystrophy, refused experimental treatment coverage. Vernon interceded, moving
up the carrier’s executive chain. It finally agreed to cover the drug for a year.

Now the child can raise his arms and offer some muscular resistance, feed himself and
play video games, greatly improving his quality of life.

“Beth will advocate again,” the attorney said. He’s hopeful that success with the first
experimental treatment will ease resistance in the future. “She has the tenacity and
persuasive skills to do it. She’s a mild-mannered pit bull.”